Next to heart disease, cancer is the leading cause of death in America. So, what's the No. 1 cause of death due to cancer? Lung cancer - and this is true for both men and women. Lung cancer kills more people than breast, prostate, colon and pancreatic cancers combined. This fact is even sadder when you realize that lung cancer is one of the most preventable forms of the disease.

"Eighty percent to 90 percent of lung cancers are caused by smoking," says Jason Chu, MD, board certified pulmonologist and critical care specialist on the medical staff at Washington Hospital. "About 45 million people in this country smoke, and there is a direct correlation between smoking and lung cancer. So, until tobacco use is sharply decreased, lung cancer will continue to be our No. 1 cancer killer."

November is Lung Cancer Awareness Month, a national campaign dedicated to turning the spotlight on lung cancer - what it is, how it can be diagnosed and treated, and how to prevent it. Every year, about 220,000 new cases of lung cancer are diagnosed and about 155,000 people die of the disease.

"These statistics really haven't changed much over time," comments Dr. Chu. "Medicine has made advances in diagnosing and treating the disease, but we haven't made in-roads into lowering the death rate."

In recent years, especially with the introduction of PET (positron emission tomography) scanning, doctors' ability to diagnose and analyze the type and severity of lung cancer has been improved. Lung cancer treatment has also advanced with more tolerable medications and less invasive surgical procedures.

PET scanning has made it possible to confirm a diagnosis of and perform the very important function of staging lung cancers - meaning that the extent to which a tumor has spread can be described. However, the fact remains that lung cancer is very difficult to diagnose early, when chances for successful treatment and longer life expectancy are greater. Currently, only about 15 percent of lung cancers are detected early.

"Symptoms from lung cancer don't usually occur in its early stages, so patients have no reason to see their doctor," reports Dr. Chu. "And, there is no way to screen for the disease. When a diagnosis of lung cancer is made early, it's usually because a doctor has been very vigilant in aggressively testing someone who is at high risk or because the patient has come in to be treated for another problem and the lung cancer is found as a result."

There are two general types of the disease: small cell lung cancer and non-small cell lung cancer. The second is far more common, accounting for nearly nine out of 10 cases. Each type grows in a different way. Small cell lung cancer is more aggressive than the non-small cell form, but it is also more responsive to treatment with chemotherapy. Unfortunately, by the time most small cell lung cancers are diagnosed, they have already spread to other areas of the body, according to Dr. Chu. Patients with this type of cancer must be treated with four or five cycles of system-wide chemotherapy. Non-small cell lung cancer can be treated with surgery, chemotherapy, radiation, or a combination of these approaches.

"Treatment can be very rigorous and difficult, so patients need to discuss the various options thoroughly with their doctors, other care providers, and their family and friends," states Dr. Chu. "When a diagnosis of lung cancer is made, everyone is affected. We need to realize that lung cancer patients can't take the journey alone."

Lung cancer treatment is usually damaging to a patient's physical well-being and quality of life, Dr. Chu explains. So, patients need lots of support from family and friends physically, emotionally and spiritually. Many patients have difficulty sleeping and are fearful of a recurrence of the disease after treatment, and it is not uncommon for them to become deeply depressed.

None of this is a pretty picture, and that's why finding ways to prevent lung cancer is critically important, expert say.

"Just think, if smoking stopped completely, we could just about wipe lung cancer off the face of the earth," advises Dr. Chu.

If you or someone you know is a smoker, remember that Thursday, Nov. 17, is the Great American Smokeout. Right now is the time to quit smoking. You'll be giving your health and the fight against lung cancer a big boost. For more information about the Smokeout, visit the American Cancer Society Web site at www.cancer.org or call toll free at 1-800-ACS-2345.